Replacing risk-based early-onset-disease prevention with intrapartum group B streptococcus PCR testing

J Matern Fetal Neonatal Med. 2017 Feb;30(3):368-373. doi: 10.3109/14767058.2016.1173030. Epub 2016 Apr 25.


Objective: To evaluate the effect of a rapid PCR-based group B streptococcus (GBS) test on length of stay in hospital among newborns, antibiotic use, and GBS-early-onset-disease (EOD) incidence.

Methods: We conducted a before and after service evaluation including term deliveries between 1st January and 12th November 2014 (6688 deliveries). Length of stay in the hospital, GBS-EOD incidence and antibiotic use were evaluated.

Results: We recorded three confirmed and 74 possible cases of GBS-EOD in Phase 1, and 85 possible cases in Phase 2. In newborns with suspected infection, the introduction of the rapid test was related to a decreased length of stay on the pediatric care unit by 1.16 days (p = 0.01), and an increase in the length of stay on the mother-and-baby ward by 1.11 days (p < 0.001). No increase in antibiotics was noted.

Conclusion: The introduction of a point of care test was associated with a reduction in length of stay in the pediatric care unit, without an increase in antibiotic use. This test could improve the accuracy of GBS colonization detection, and help to prevent intrapartum transmission as no verified GBS-EOD cases were recorded with the intrapartum PCR algorithm.

Keywords: GBS early onset disease; group B streptococcus; neonates; observational study; rapid diagnostic test.

Publication types

  • Observational Study

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis
  • Female
  • Humans
  • Incidence
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Length of Stay / statistics & numerical data
  • Penicillin G / therapeutic use
  • Perinatal Care / methods*
  • Point-of-Care Systems*
  • Polymerase Chain Reaction
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis*
  • Pregnancy Complications, Infectious / epidemiology
  • Pregnancy Complications, Infectious / prevention & control
  • Risk Assessment
  • Streptococcal Infections / diagnosis*
  • Streptococcal Infections / epidemiology
  • Streptococcal Infections / prevention & control
  • Streptococcal Infections / transmission
  • Streptococcus agalactiae / genetics
  • Streptococcus agalactiae / isolation & purification*
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Penicillin G